精神分裂症與功能復原

Functional Recovery in Schizophrenia

背景：精神分裂症已經長期被嚴重污名化，而近幾年來復原概念則成為整合精神分裂症醫療服務使命的重要依據。方法：本文藉由完整的文獻回顧，介紹精神分裂症復原概念的發展新趨勢。結果：有關復原的科學性定義，將它視為一種量化、客觀及成果導向的概念，強調疾病的呈現、症狀與功能性障礙。相對地，消費者導向的定義則將復原視為一種質性、主觀與流程導向的概念，強調隨時間轉變、非線性與照護模式的意涵。兩種不同的概念應被視為功能互補，共同引導服務模式的建立。此外，整合一學、心理、病人、家庭及社會介入，有助於促進復原的可能。結論：科學文獻指出約有一半的精神分裂症患者，在一生的病程當中會有某些時期符合復原的定義，而且從精神分裂症復原，將對社會與醫療經濟帶來重大的益處。因此復原不僅是可達成的目標，而且是相當值得在全世界推廣的概念。

Background: Schizophrenia has been severely stigmatized for several decades. In recent years, the concept of “recovery” has been suggested as the critical mission to help integrate all efforts of services in schizophrenia. Method: We did a comprehensive review on 59 published articles in the literature to examine the developing concept of recovery in schizophrenia. Results: We found that scientifi c defi nitions dealt recovery in schizophrenia as quantitative, objective, outcome-focused on the manifestations of the illness, symptoms, and functional disability. In contrast, we found that consumer-oriented defi nitions regarded it as qualitative, subjective, process-focused on occurrence over time with a non-linear fashion and to the model of care. These two different concepts of recovery should be treated as complementary and combined as a guidance for designing recovery-oriented services. Medical, psychological, patient, family, and social intervention should be integrated to enhance the possibility of recovery. Conclusion: Scientifi c literature showed that around a half of schizophrenic patients has met the objective criteria of recovery for certain periods during their lives. We suggest that recovery from schizophrenia is desirable from both social and economic perspectives, and that recovery is an attainable goal and needs to be promoted worldwide.